| NPI | 1578815510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17487) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH12150) |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2021-11-04 |