| NPI | 1174041024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CCMH0187841) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0170981) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2019-02-04 |