| NPI | 1215536834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC9850) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701012404) |
| 101YM0800X Counselor Mental Health (Licence: DC PRC200001498) | |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2024-08-28 |