| NPI | 1104364462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 252474) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 255414) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2025-01-27 |