| NPI | 1841551363 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 13129) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2012-05-31 | 
| Last Update Date | 2016-06-21 |