| NPI | 1174072185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0018112) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2014005305) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2022-08-01 |