| NPI | 1780393363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2023-01-17 |