| NPI | 1073933982 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 780) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 3288) | 
| 101YP2500X Counselor, Professional (Licence: CA 3288) | |
| 101YP2500X Counselor, Professional (Licence: MN 780) | |
| Enumeration Date | 2014-04-17 | 
| Last Update Date | 2022-04-27 |