| NPI | 1679967723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 6750) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 6750) |
| 101Y00000X Counselor (Licence: SC 6750) | |
| 101YM0800X Counselor, Mental Health (Licence: ME 6820) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-01-10 |