| NPI | 1124733530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 17114) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH13560) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-01-19 |