| NPI | 1861564890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10947) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 6006) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2015-07-17 |