| NPI | 1053755025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 88514) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: PA PC008555) |
| 101YP2500X Counselor Professional (Licence: PA PC008555) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2023-06-25 |