| NPI | 1003410226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0704010696) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0733007161) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0732001489) | |
| Enumeration Date | 2020-11-29 |
| Last Update Date | 2020-11-29 |