| NPI | 1679543086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401015571) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH3829) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-01-18 |