| NPI | 1790902419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 5406) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NH 2300) |
| 101YM0800X Counselor Mental Health (Licence: ME CC6074) | |
| 101YM0800X Counselor Mental Health (Licence: NH 619) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-01-26 |