| NPI | 1700319951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO LPC.0016165) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional (Licence: CO LPC.0016165) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2020-04-15 |