| NPI | 1790188530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH60146449) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH E.0500282-SUPV) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-08 |