| NPI | 1740701374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2017042558) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2017042558) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2021-11-16 |