| NPI | 1619419678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2145) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10531) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2019-06-20 |