| NPI | 1124590989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14074) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 82853) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2020-08-04 |