| NPI | 1023447034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC5120) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC5120) |
| 101YP2500X Counselor Professional (Licence: MD LC5120) | |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2024-01-30 |