| NPI | 1386336279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-65908) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC.0021045) |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2024-10-16 |