| NPI | 1104300813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC11174) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LG8530) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2021-04-09 |