| NPI | 1174908503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401014949) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014949) | 
| Enumeration Date | 2015-07-27 | 
| Last Update Date | 2019-10-03 |