| NPI | 1902037278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 7169) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MA 147931) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2012-05-16 |