| NPI | 1417359209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2040) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MS 2040) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2022-11-07 |