| NPI | 1053864660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 6573) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 6573) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH 13801) | |
| 101YM0800X Counselor, Mental Health (Licence: LA 6573) | |
| Enumeration Date | 2016-07-31 |
| Last Update Date | 2018-12-07 |