| NPI | 1790046266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2022034552) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2022034552) |
| 225200000X Physical Therapy Assistant (Licence: MO 2008031000) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2024-11-25 |