| NPI | 1679318604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS LPC03793) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2021050553) |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |