| NPI | 1639830821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6451019802) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6451019802) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-19 |