| NPI | 1326762980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0704014451) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 010959) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |