| NPI | 1578183745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6542) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH11664) |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |