| NPI | 1619386521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA 60497185) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 100504) |
| 171400000X | |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2023-05-25 |