| NPI | 1134728181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR C7603) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-64926) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2024-01-10 |