| NPI | 1780724039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 1038) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 2998) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |