| NPI | 1619372638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2012014744) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2012014744) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2012014744) | |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2022-11-22 |