| NPI | 1316579964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 6855) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 6855) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2022-08-16 |