| NPI | 1073906640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC PRC14767) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC6192) |
| 101YP2500X Counselor, Professional (Licence: MD LC6192) | |
| 101YP2500X Counselor, Professional (Licence: DC PRC14767) | |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2020-07-28 |