| NPI | 1255784534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0015419) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0014752) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2019-07-18 |