| NPI | 1073892840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 12548) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 8980) |
| 101YM0800X Counselor, Mental Health (Licence: AZ 22147) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2023-08-01 |