| NPI | 1780222117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2019045776) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2019045776) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2019045776) | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |