| NPI | 1376956193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: NM CCMH0195541) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM CCMH0195541) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2023-07-05 |