| NPI | 1639699895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH18316) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC.0016879) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-04-22 |