| NPI | 1679123400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MT3869) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMT2664) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2021-11-19 |