| NPI | 1285088260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 16243) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 16243) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: NC 16243) | |
| Enumeration Date | 2016-04-16 |
| Last Update Date | 2024-10-28 |