| NPI | 1093189896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14151) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701007296) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH12076) | |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2018-06-17 |