| NPI | 1376190512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO 0019072) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YM0800X Counselor Mental Health (Licence: CO 0018044) | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2024-04-09 |