| NPI | 1376093351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 11737) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional (Licence: NJ 37PC00813700) | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2022-10-31 |