| NPI | 1760898688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 3286) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YM0800X Counselor, Mental Health (Licence: NY 009917) | |
| 101YM0800X Counselor, Mental Health (Licence: MA 9910) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2019-10-29 |