| NPI | 1104585561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC012353) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 009101-1) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2021-12-14 |