| NPI | 1255700464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0016128) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401014217) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2020-12-22 |