| NPI | 1710423116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 4652416922) |
| Additional Taxonomies | 251S00000X (Licence: VA 2574-03-001) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2018-03-12 |