| NPI | 1700543014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC8982) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC8982) |
| 101YP2500X Counselor Professional (Licence: MD LC8982) | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2022-02-11 |