| NPI | 1104103332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV CI5097) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NV 26-4620648) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2022-04-29 |