| NPI | 1790020766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A16006) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2022-01-06 |