| NPI | 1306229737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 072148) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0135436TELE) |
| 101YP2500X Counselor, Professional (Licence: WI 10444-125) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2023-10-10 |