| NPI | 1972597243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701003823) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001093813) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2009-09-10 |