| NPI | 1962491407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA SW124731) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 44SC04734600) |
| 101YM0800X Counselor, Mental Health (Licence: NY 044809-1) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2014-03-05 |