| NPI | 1760794739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 472) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3140) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2010-07-07 |