| NPI | 1902006133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180.008713) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.008713) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2013-07-18 |