| NPI | 1760839914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 6550) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 6550) |
| 251S00000X (Licence: MA 6550) | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |