| NPI | 1720351273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK Supervision) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR 1896) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2016-07-11 |