| NPI | 1790223758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6557) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC15110) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC11076) | |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2023-12-12 |