| NPI | 1689055485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC4888) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME XL4544) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2020-08-13 |