| NPI | 1912993825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00175) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 00439) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2007-07-08 |