| NPI | 1639570591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401017942) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401014477) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2020-11-13 |