| NPI | 1720351976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH2248) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPC7209) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2020-12-06 |