| NPI | 1639577463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KS 2388) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 2388) |
| 101YP2500X Counselor Professional (Licence: MO 2006012555) | |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2023-12-11 |