| NPI | 1205394293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 7716-125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 7716-125) |
| 101YM0800X Counselor Mental Health (Licence: WI 3957-226) | |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2021-10-14 |