| NPI | 1780693994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 27) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: IA T058065) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |