| NPI | 1801566229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-57718) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-PCLC-LIC-50256) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2022-11-03 |