| NPI | 1790903300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH20261) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SD 825) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2019-09-26 |