| NPI | 1679218036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH21370) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH20152) |
| Enumeration Date | 2022-04-30 |
| Last Update Date | 2022-10-12 |