| NPI | 1245768639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R5350) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 22404) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2019-05-08 |