| NPI | 1114479508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LPC5208) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-8613) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2022-05-19 |