| NPI | 1720650427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 105636) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801110601) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2022-01-21 |