| NPI | 1518510403 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0134918)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 097.0134537)  | 
| Enumeration Date | 2019-07-19 | 
| Last Update Date | 2022-11-17 |