| NPI | 1740553965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.000636) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 6336) |
| Enumeration Date | 2012-02-18 |
| Last Update Date | 2021-05-31 |