| NPI | 1720759350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 5741) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CT 5187) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2024-07-12 |