| NPI | 1467124347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM CCMH0208221) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2024-04-10 |