| NPI | 1124716360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701013799) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0704008184) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-09-13 |