| NPI | 1790848661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2004011201) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 2004011201) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-01-11 |