| NPI | 1790398667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 115555-MH-CC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 007029-1) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |