| NPI | 1063976603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 101YM0800X Counselor Mental Health (Licence: MA 13238) | |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2024-11-08 |