| NPI | 1871040238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5623-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 004854-1) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2016-09-02 |