| NPI | 1447803960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 094889) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 63796) |
| 163W00000X Registered Nurse (Licence: IA 145030) | |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |