| NPI | 1336854512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-64776) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-64776) |
| 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-64776) | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-10-13 |