| NPI | 1316293665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401011384) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401011384) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2019-08-22 |