| NPI | 1679960876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC01592) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM CCMH0209151) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2024-04-12 |