| NPI | 1679142483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH18894) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH20021) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-12-20 |