| NPI | 1891802534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MO LPC 00431) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO LCSW 000446) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |