| NPI | 1255803177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 90097) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6801107678) |
| 101Y00000X Counselor (Licence: MI 6401016991) | |
| 101YP2500X Counselor, Professional (Licence: MI 6401222507) | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2023-12-20 |