| NPI | 1831122050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH11999) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301012760) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2023-11-27 |