| NPI | 1194015719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401008973) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401008973) | 
| 101YP2500X Counselor, Professional (Licence: MI 6401008973) | |
| Enumeration Date | 2011-04-15 | 
| Last Update Date | 2021-03-12 |