| NPI | 1609115518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LPC.0016838) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0015273) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2021-03-30 |