| NPI | 1194253294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 7073) |
| 101YP2500X Counselor Professional (Licence: LA 7073) | |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-10-31 |