| NPI | 1639786841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 6001) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CT 4500) |
| 101YM0800X Counselor Mental Health (Licence: ME CC7020) | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2023-04-28 |