| NPI | 1770143554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC01148) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401223509) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2023-10-02 |