| NPI | 1497026801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH30584) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SD LPC7197) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2019-10-23 |