| NPI | 1124412549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LC2345) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC2345) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2018-01-11 |