| NPI | 1407459118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401018702) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 86618) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6451018702) | |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2024-09-02 |