| NPI | 1639453897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-1524) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT 1524) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2022-09-21 |