| NPI | 1164057634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0704011628) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: VA 03-123) |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-03-05 |