| NPI | 1063907822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 11905877-6009) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-01-14 |