| NPI | 1457199283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-72519) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-PCLC-LIC-48957) |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-08-26 |