| NPI | 1649763863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC4375) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC4375) |
| 101YP2500X Counselor, Professional (Licence: MD LC4375) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-05-12 |