| NPI | 1649687757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 172708) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 10026) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2017-05-03 |