| NPI | 1255803458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401010654) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401010654) |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2019-02-01 |