| NPI | 1750053120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6451022608) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6362009364) |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2023-09-22 |