| NPI | 1770936346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH20222) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: PR 4770) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-01-29 |