| NPI | 1003956897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD 2129) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SD SD1003) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2023-09-25 |