| NPI | 1124633219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10980) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV 2722) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2023-03-09 |