| NPI | 1174135651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701009763) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701009763) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2023-01-09 |