| NPI | 1679116669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CCMH0222831) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM T-CTL0206531) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2024-01-05 |