| NPI | 1770054629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 3146) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AL 3146) |
| 101YP2500X Counselor Professional (Licence: AL 3146) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |