| NPI | 1518104090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC005603) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC5603) |
| 101YM0800X Counselor Mental Health (Licence: UT 7115918-6009) | |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2022-07-21 |