| NPI | 1073943858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701007530) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 72866) |
| 101YM0800X Counselor, Mental Health (Licence: MD LGP5140) | |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2021-09-13 |