| NPI | 1366794810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-20418) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: SD LPC-20418) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2024-05-03 |