| NPI | 1669939195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM CMH0204591) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM T-CTL0202511) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-08-21 |