| NPI | 1174993596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH13852) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: PA PC006451) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2020-09-28 |