| NPI | 1679026868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 1986) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2022-08-18 |