| NPI | 1710391164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 01917) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 072366) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2018-04-17 |