| NPI | 1245993047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 5134) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 011224) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-10-19 |