| NPI | 1720697253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6451018337) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401018337) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2022-03-10 |