| NPI | 1356811640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC10952) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP9124) |
| 101YM0800X Counselor, Mental Health | |
| 101YM0800X Counselor, Mental Health (Licence: PA PC014553) | |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2022-11-04 |