| NPI | 1790144715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401006446) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401006446) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |