| NPI | 1811303506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AL C2138A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AL 3556) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-07-02 |