| NPI | 1093064974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LGP4058) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC4862) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2021-09-17 |