| NPI | 1710382262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401014403) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 64011014403) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2018-10-22 |