| NPI | 1285174441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401011699) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401011699) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2018-10-01 |