| NPI | 1790138758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 3724) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IA 082380) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2025-05-20 |