| NPI | 1700158698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6081) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 11078) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2023-03-01 |