| NPI | 1003954025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401006716) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI L912751) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2022-12-02 |