| NPI | 1366749004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CTB-2023-0939) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 17178) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2023-11-13 |