| NPI | 1487417580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LGP14768) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 91481) |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |