| NPI | 1639444151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 2023) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WV 2023) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2020-04-02 |