| NPI | 1972546505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: RI MHC00185) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5180) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2007-07-08 |