| NPI | 1740696863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14472) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 9661) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2019-01-28 |