| NPI | 1477168300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |