| NPI | 1164760872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH16432) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH10842) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2023-01-23 |