| NPI | 1811394539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R-3142) |
| 133V00000X Dietitian, Registered | |
| 133V00000X Dietitian, Registered (Licence: OR LD-D-10156897) | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2019-02-07 |