| NPI | 1659785319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 10758) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 6216) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2017-12-17 |