| NPI | 1861755308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 13687) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH10339) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2017-12-15 |