| NPI | 1790814549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.005672) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2022-07-21 |