| NPI | 1649818824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: RI MHC01409) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701008826) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2024-08-03 |