| NPI | 1609473750 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC LGPC00541) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP9539) | 
| Enumeration Date | 2020-10-01 | 
| Last Update Date | 2020-10-01 |