| NPI | 1174104608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0704011925) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701010536) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-06-11 |