| NPI | 1417495391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NH 1238) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: RI MHC00858) |
| 101YM0800X Counselor Mental Health (Licence: MA 10391) | |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2021-10-06 |