| NPI | 1679300727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: NJ 37PC00564500) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37PC00564500) |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00564500) | |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00564500) | |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-13 |