| NPI | 1790129799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 10542) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 10542) |
| 101YM0800X Counselor, Mental Health (Licence: NC 10543) | |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2018-10-15 |