| NPI | 1033625645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LSW.0009925776) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CO 0000951) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2024-10-23 |