| NPI | 1124750856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701011567) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701011567) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0701011567) | |
| 101Y00000X Counselor (Licence: VA 0701011567) | |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |