| NPI | 1164976163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-7036) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-6285) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2020-06-01 |