| NPI | 1568976116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0013995) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0013995) |
| 252Y00000X Early Intervention Provider Agency (Licence: CO LPC.0013995) | |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2022-07-21 |