| NPI | 1265913974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LGP8799) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LGP8799) |
| 101YP2500X Counselor Professional (Licence: MD LGP8799) | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2020-09-23 |