| NPI | 1205377256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0016711) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: UT 10134344-6009) |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2021-08-14 |