| NPI | 1255967493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17898) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60479854) |
| 101YP2500X Counselor, Professional (Licence: GA LPC008646) | |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00532200) | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2021-07-14 |