| NPI | 1801205497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM CCMH0213581) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0175471) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2022-07-27 |