| NPI | 1114653532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0021623) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0019760) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2024-12-05 |