| NPI | 1043720055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC8320) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP6737) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2021-10-14 |