| NPI | 1407399959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 9568123) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 130451-121) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2021-06-16 |