| NPI | 1205335130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0102645) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 1997) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-03-16 |