| NPI | 1063764157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR L8553) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: Pending) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2021-02-23 |