| NPI | 1417399619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO 0012707) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPCC.0013473) |
| 101YP2500X Counselor Professional (Licence: CO 0012707) | |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2022-12-31 |