| NPI | 1639753411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 5007) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 4254) |
| Enumeration Date | 2021-05-08 |
| Last Update Date | 2021-11-20 |