| NPI | 1053825240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: DC PRC15001) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LGP7511) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |