| NPI | 1740489665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY 1003) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 576) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2014-11-10 |