| NPI | 1225079429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT LCPC1021) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT 1021LCPC) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-11-27 |