| NPI | 1003261132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 5946-125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-49267) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2024-03-12 |