| NPI | 1376824193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VT 097.0086774) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2019-10-09 |