| NPI | 1740265222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 077931) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 28764) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2024-10-07 |