| NPI | 1578024766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC10853) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD lgp8286) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2022-04-06 |