| NPI | 1700358520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 088805) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.009300) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2018-12-18 |