| NPI | 1134582992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-16606) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SD LPC7364) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2018-05-21 |