| NPI | 1770180572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 9122) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC12754) |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2023-09-30 |