| NPI | 1811395007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 60564407) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 9053) |
| Enumeration Date | 2014-12-20 |
| Last Update Date | 2015-11-24 |