| NPI | 1508566514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC15804) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP13232) |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2024-11-04 |