| NPI | 1609397918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CT 003169) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 003169) |
| 101YP2500X Counselor, Professional (Licence: 003169) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2021-06-02 |