| NPI | 1154776524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: DC PRC15066) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC7873) |
| 164W00000X Licensed Practical Nurse (Licence: DC LPN1006945) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2023-09-01 |