| NPI | 1790848091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701004918) |
| Additional Taxonomies | 174400000X Specialist |
| 101YM0800X Counselor, Mental Health (Licence: MA 6544) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-11-02 |