| NPI | 1679080527 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15582) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E1600036) | 
| Enumeration Date | 2018-01-01 | 
| Last Update Date | 2018-01-01 |