| NPI | 1619566569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-LIC-48096) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-48096) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |