| NPI | 1174008395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM CCMH0214071) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM CMH0199611) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2022-07-05 |