| NPI | 1679839542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A18236) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 8148206-6009) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2022-12-08 |