| NPI | 1356654057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-43684) |
| Additional Taxonomies | 101Y00000X Counselor |
| 225700000X Massage Therapist (Licence: MT 570343-09) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2020-07-16 |