| NPI | 1336780154 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC13294)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC013724)  | 
| Enumeration Date | 2019-10-02 | 
| Last Update Date | 2024-06-18 |