| NPI | 1376190173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME XL5078) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME CC6219) | 
| Enumeration Date | 2019-08-26 | 
| Last Update Date | 2022-02-02 |