| NPI | 1639519085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC7864) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP6452) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2017-06-14 |