| NPI | 1023604808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-46221) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-46221) |
| 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-46221) | |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2020-12-16 |