| NPI | 1790792182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2001011585) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-02-11 |