| NPI | 1023554755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20740) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0134533TELE) |
| 101YM0800X Counselor, Mental Health (Licence: MA 11872) | |
| 101YM0800X Counselor, Mental Health (Licence: PA PC016430) | |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2023-12-13 |