| NPI | 1053775387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH17310) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 005545) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2021-02-20 |