| NPI | 1245742410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10727) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH15417) |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2020-11-15 |