| NPI | 1316199920 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 9410759-6004)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401002882)  | 
| 101YP2500X Counselor, Professional (Licence: UT 9410759-6004)  | |
| Enumeration Date | 2008-10-14 | 
| Last Update Date | 2020-09-17 |