| NPI | 1720351109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: LA 200215) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2017-05-09 |