| NPI | 1376092098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180.011913) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 178.011744) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2020-02-05 |