| NPI | 1912034612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 9700041) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A16413) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2023-05-18 |