| NPI | 1750013520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701013598) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN 5769) |
| 163W00000X Registered Nurse (Licence: TN 233596) | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2024-05-22 |