| NPI | 1710400650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16531) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH15413) |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2021-04-22 |