| NPI | 1720494164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC9365) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: MD LGP7829) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2022-07-21 |