| NPI | 1760826861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0012251) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 006292) |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2021-10-08 |