| NPI | 1356875314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 107896) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 37086) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-06-07 |