| NPI | 1699203521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2017014819) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2017014819) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2019-07-11 |