| NPI | 1952465551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL 14247) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 2983-125) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2016-06-27 |