| NPI | 1164840476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12689) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-03-09 |