| NPI | 1760498604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC00267) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 5448) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2023-03-01 |