| NPI | 1063848695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 17647) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH11865) |
| Enumeration Date | 2013-09-14 |
| Last Update Date | 2023-12-14 |