| NPI | 1790775468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD 2074) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R014691) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-07-08 |