| NPI | 1255624599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC0011508) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 9398) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2023-07-01 |