| NPI | 1811436702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR R5745) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 22466) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2019-08-14 |