| NPI | 1780040428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH11681) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH11681) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2020-02-25 |