| NPI | 1629596002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 11505) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: MA 11505) | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2020-06-23 |