| NPI | 1457813461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10002127) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-10-14 |