| NPI | 1275058836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC7969) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC7969) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC7969) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2018-05-11 |