| NPI | 1245975895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-70116) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT BBH-MFLC-LIC-55294) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2024-02-05 |