| NPI | 1609252857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM CCMH0184631) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0175651) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2022-01-28 |