| NPI | 1255763538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 5987-125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 1841-226) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2020-03-04 |