| NPI | 1235881418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VT 0680134443) |
| Additional Taxonomies | 225600000X Dance Therapist (Licence: R-DMT-2658) |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-01-20 |