| NPI | 1720703580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61272503) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC12502) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |