| NPI | 1023557378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MHC00951) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: MA 220-MH-CC-TEMP) | |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2021-03-16 |