| NPI | 1730104688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO 0017296) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KS 2387) |
| 101YP2500X Counselor Professional (Licence: VA 0701003510) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-03-28 |