| NPI | 1891043428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC5471) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP4240) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2015-03-20 |