| NPI | 1275351207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2023050858) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KS LPC04210) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-11-04 |