| NPI | 1679040547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC12255) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP9138) |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2022-01-17 |