| NPI | 1053877662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16465) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC8668) |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |