| NPI | 1194808105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-1174) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 1174) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-05-07 |