| NPI | 1184288136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701008253) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0701008253) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |