| NPI | 1760461982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2000167854) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2000167854) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2020-12-21 |