| NPI | 1578048500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MH15778) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MH15778) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2019-01-29 |