| NPI | 1780803049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 3354) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 8185) |
| 101YM0800X Counselor, Mental Health (Licence: WY 1839) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-09-29 |