| NPI | 1053938456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH-30654SUP) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SD LPC20534) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2021-08-21 |