| NPI | 1770589962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00363) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 89-182) |
| 101YM0800X Counselor, Mental Health (Licence: 43725) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 908) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 1189) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 1406) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2021-07-28 |