| NPI | 1821090812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 928) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: SC 208685) |
| 163W00000X Registered Nurse (Licence: SC 41,401) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |