| NPI | 1619456902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC14574) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LPG10215) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2025-08-17 |