| NPI | 1104446665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH20110) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH18232) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-01-05 |