| NPI | 1588910038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-5758) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-5758) |
| 101YP2500X Counselor, Professional (Licence: ID LPC5069) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2024-06-20 |