| NPI | 1790976165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 7155) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A11587) |
| 101YM0800X Counselor, Mental Health (Licence: SC 7155) | |
| 101YP2500X Counselor, Professional (Licence: NC A11587) | |
| 251S00000X | |
| 251S00000X (Licence: 7155) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2019-06-18 |