| NPI | 1114437191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH17649) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 8226) |
| 101YM0800X Counselor Mental Health (Licence: WA LH61254759) | |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2023-02-07 |