| NPI | 1306554597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO 0018068) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KS 04189) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |