| NPI | 1891862371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39000937) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IN 34002469) |
| 106H00000X Marriage & Family Therapist (Licence: IN 35001258) | |
| 163WG0000X Registered Nurse General Practice (Licence: IN 28064495) | |
| 163WG0000X Registered Nurse General Practice (Licence: MA 119412) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |