| NPI | 1013367762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12143-MH-CC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 120900) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2021-09-26 |