| NPI | 1609292812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL 13644) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 11593) |
| 101YP2500X Counselor, Professional (Licence: FL IMH 11593) | |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2020-12-31 |