| NPI | 1912327826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11757) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A11757) |
| 164W00000X Licensed Practical Nurse (Licence: NC 026835) | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2022-05-01 |