| NPI | 1629475058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-9297) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0134346) |
| 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-9297) | |
| 101YP2500X Counselor, Professional (Licence: VT 068.0134346) | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2022-01-06 |