| NPI | 1255761953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 15790) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-15790) | |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2018-09-27 |