| NPI | 1720624570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11573) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP9094) |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2021-09-17 |