| NPI | 1700121704 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002888A) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.0700436-SUPV) | 
| 101YP2500X Counselor, Professional (Licence: DC PRC14600) | |
| Enumeration Date | 2012-12-01 | 
| Last Update Date | 2023-01-25 |