| NPI | 1770619736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 3343) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7078) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-07-05 |