| NPI | 1508142977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN LPC7580) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM T-0144351) |
| 101YP2500X Counselor Professional (Licence: NM CCMH0217321) | |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2024-11-08 |