| NPI | 1497254783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LPC-6772) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ID LPC-6772) |
| 101YP2500X Counselor Professional (Licence: ID LPC-6772) | |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2018-04-23 |