| NPI | 1235774696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC13328) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701010214) |
| 163W00000X Registered Nurse (Licence: VA 0001152431) | |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2023-12-20 |