| NPI | 1750775243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH13386) |
| 251S00000X Community/Behavioral Health (Licence: FL MH13386) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2017-06-06 |