| NPI | 1912338575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH10721) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO NLC.0013234) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-13 |