| NPI | 1407066749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AK PCOP584) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AK PCOP584) |
| 101YM0800X Counselor Mental Health (Licence: NM 0101611) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-03-21 |