| NPI | 1043685282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401015139) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 1932343) |
| Enumeration Date | 2015-12-13 |
| Last Update Date | 2021-11-03 |