| NPI | 1952302069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA 1179) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 1179) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |