| NPI | 1508210642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2394) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10823) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2020-05-18 |