| NPI | 1104965912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 7005) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 90269) |
| 101YP2500X Counselor, Professional (Licence: CT 5924) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-10-24 |