| NPI | 1760059166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC11669)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH20165)  | 
| 101YM0800X Counselor, Mental Health (Licence: MD LGP9734)  | |
| Enumeration Date | 2021-06-06 | 
| Last Update Date | 2022-09-04 |