| NPI | 1104105378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0016354) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0016354) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2021-03-04 |