| NPI | 1821414657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 6638) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 12060) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2019-07-10 |