| NPI | 1184106692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO NLC.0012885) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2019-05-31 |