| NPI | 1710175153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH11279) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 000413) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2021-04-19 |