| NPI | 1659793792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS LCPC-2682) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-806) |
| 101YM0800X Counselor, Mental Health (Licence: KS LPC-2826) | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2021-06-28 |