| NPI | 1750570719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VT 068.0134143) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 6164) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2024-01-24 |