| NPI | 1659961688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LGP11107) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LGP11107) |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2021-01-23 |