| NPI | 1780004762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0012578) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPP.0001311) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2023-03-15 |