| NPI | 1740723816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 080320) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1239) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |