| NPI | 1063064574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 19460) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 11076A) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2025-01-15 |