| NPI | 1760761233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2011026053) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 2011026053) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2019-10-08 |