| NPI | 1780143669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM CCMH0223961) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM TCTL0200981) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-09-21 |