| NPI | 1790174506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC7193) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC7193) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC7193) | |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2017-02-23 |