| NPI | 1235604901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: BH003409) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC11612) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2022-09-12 |