| NPI | 1023604386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6451024097) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6451024097) |
| 374700000X Technician | |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2025-05-28 |