| NPI | 1720816580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-69985) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT BBH-LCPC-69985) |
| 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-69985) | |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-07-23 |