| NPI | 1639459092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401011967) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 64010111967) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2022-08-23 |