| NPI | 1295230373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC LCMHC15433) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LPC-6756) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2020-10-14 |