| NPI | 1801857800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA Master) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 092006877RN) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |