| NPI | 1790259802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC11955) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP9102) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2023-01-31 |