| NPI | 1669075214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: LA 536307) |
| 101YM0800X Counselor, Mental Health | |
| 251B00000X Case Management | |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2020-12-22 |