| NPI | 1790143394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6801064911) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6801064911) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-02-10 |