| NPI | 1114491362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 2650) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MS p-0193) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2022-02-09 |