| NPI | 1386112852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC9743) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP8158) |
| 101YM0800X Counselor Mental Health (Licence: MD LGP8158) | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2019-07-31 |