| NPI | 1720242399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401224437) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401224437) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.016233) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2025-01-16 |