| NPI | 1033849633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 12103709-6009) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: UT 12103709-4002) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-11-13 |