| NPI | 1629612601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0732004950) |
| Additional Taxonomies | 172A00000X Driver (Licence: VA T63352202) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-11-01 |