| NPI | 1174115349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 11210) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC5634) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2021-02-09 |