| NPI | 1255899852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC8497) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL 1622) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2024-07-29 |