| NPI | 1619314952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401013649) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC19941) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2024-07-24 |