| NPI | 1700423092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 002648) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401008079) |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2019-12-05 |