| NPI | 1235463621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9872) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 9729) |
| 101YP2500X Counselor, Professional (Licence: CA 2261) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2022-07-21 |