| NPI | 1407401185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 3113) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2022-09-29 |