| NPI | 1104247006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM 0160451) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: NM 0196451) | |
| 101YM0800X Counselor Mental Health (Licence: NM CCMH0196451) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2021-08-27 |