| NPI | 1255844031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC5341) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 9202) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2022-03-22 |