| NPI | 1063982122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701008939) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2021-04-06 |