| NPI | 1760634216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0152551) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0105341) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2012-10-26 |