| NPI | 1376009357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 2485) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 11741) |
| 101YM0800X Counselor Mental Health (Licence: IA 111480) | |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2022-06-30 |