| NPI | 1730582354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 13073) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-09-28 |
| Last Update Date | 2022-05-03 |