| NPI | 1396388450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-45820) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC19262) |
| 101YM0800X Counselor Mental Health (Licence: MT BBH-PCLC-LIC-38320) | |
| 101YM0800X Counselor Mental Health (Licence: NV CPC5265R) | |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2024-10-31 |