| NPI | 1043415912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-1393) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 6953) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-09-17 |