| NPI | 1114358660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C8286) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP11355) |
| 101YM0800X Counselor, Mental Health (Licence: AL LPC05181) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 14816) | |
| 101YM0800X Counselor, Mental Health (Licence: UT 12852525-6009) | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2024-10-17 |