| NPI | 1700135753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 5519) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 11416) |
| 101YM0800X Counselor, Mental Health (Licence: PA 006522) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2022-10-06 |