| NPI | 1396179081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11114) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT SWP-LCPC-LIC-4600) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2021-01-07 |