| NPI | 1548686454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 083444) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 5017-125) |
| Enumeration Date | 2014-03-16 |
| Last Update Date | 2022-12-22 |