| NPI | 1699136630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-190) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-190) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-18 |