| NPI | 1730555095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0117129) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VT 0970081292) |
| 101YM0800X Counselor, Mental Health (Licence: MA 8954) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2019-04-24 |