| NPI | 1174055016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 2410) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 380) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2020-10-01 |