| NPI | 1821498833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 247200000X Technician, Other | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 101YM0800X Counselor, Mental Health (Licence: FL MH18209)  | |
| Enumeration Date | 2014-08-27 | 
| Last Update Date | 2021-01-25 |