| NPI | 1760541981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 888) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MA 77674) |
| 225400000X Rehabilitation Practitioner (Licence: MA 433) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |