| NPI | 1619367042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 12174) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 005914) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2019-05-22 |