| NPI | 1639422389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 6069) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: WI 6069) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2024-07-30 |