| NPI | 1780142711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC11053) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701007878) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2021-04-09 |