| NPI | 1093072506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KS 2606) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 0012583) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2022-12-20 |