| NPI | 1821459173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 13218) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2023-02-17 |