| NPI | 1629752415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 90673) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 097.0135752) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-12 |