| NPI | 1750836474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4762) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0101813) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |