| NPI | 1215491584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12981) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2022-03-30 |