| NPI | 1568732543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH12700) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH 9543) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2023-05-01 |