| NPI | 1578967022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0017110) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2022-11-30 |