| NPI | 1770028979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2015019406) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2015019406) |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2017-07-07 |