| NPI | 1619511185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401005897) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2024-03-12 |