| NPI | 1114526654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 4876376-6004) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 17321) |
| Enumeration Date | 2020-10-24 |
| Last Update Date | 2020-10-24 |