| NPI | 1770130460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR C6546) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH E.1901306) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2022-11-04 |