| NPI | 1811280639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4850) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 7304) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2018-09-24 |