| NPI | 1376998302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12006) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MA 12006) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2022-09-08 |