| NPI | 1053736264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 5824) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 10978) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2024-02-16 |