| NPI | 1265891568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC6720) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC6720) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2023-12-15 |