| NPI | 1639155781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 19009) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 011694-01) |
| 101YP2500X Counselor, Professional (Licence: IL 180-004968) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2024-06-20 |