| NPI | 1700213568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC S10125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC S10125) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2024-02-07 |