| NPI | 1689051237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14545) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL MH14545) |
| 101YP2500X Counselor, Professional (Licence: FL MH14545) | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-03-03 |