| NPI | 1083139752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC5757) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC5757) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2018-03-17 |