| NPI | 1134762057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC11443) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP8481) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2021-12-16 |