| NPI | 1104410828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: 6401017169) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401017169) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2022-03-04 |