| NPI | 1114371291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 6203) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 6203) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-08-23 |