| NPI | 1174073928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19776) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2023-08-21 |