| NPI | 1720699424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-43898) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-43898) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2022-03-01 |