| NPI | 1356897151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6451022869) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2023-06-22 |