| NPI | 1821764580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8856) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-50264) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-12-09 |