| NPI | 1023644598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 16793) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0016135) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-03-07 |