| NPI | 1689200453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-8108) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-7627) |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2021-05-18 |