| NPI | 1043840002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 40196) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH16520) |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2024-05-29 |