| NPI | 1700459575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 8219) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL TPMC4866) |
| 101YM0800X Counselor, Mental Health (Licence: DE MI-0000180) | |
| 101YM0800X Counselor, Mental Health (Licence: MA LMHC10001993) | |
| 101YP2500X Counselor, Professional (Licence: SC 8219) | |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-12-13 |