| NPI | 1104217322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C1300117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E1300117-SUPV) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2019-07-31 |