| NPI | 1124833058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: NE 3747P1801X) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 3747P1801X) |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-10 |