| NPI | 1457868481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC10509) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 008398) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2021-11-17 |