| NPI | 1619384443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0203471) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0169821) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2019-04-16 |