| NPI | 1952415135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0005107) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 408) |
| 101YM0800X Counselor, Mental Health (Licence: KS 2125) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-10-14 |