| NPI | 1215295720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 8105) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 9146) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2025-04-02 |