| NPI | 1902937287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180005726) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: IL n/a) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-01-08 |