| NPI | 1700288065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0012079) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 0012079) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2024-06-10 |