| NPI | 1760045744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180.011848) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.011848) |
| 101YP2500X Counselor Professional (Licence: IL 180.011848) | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-06-18 |