| NPI | 1104390657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8027) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YM0800X Counselor, Mental Health (Licence: LA PLC8027) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-04-05 |