| NPI | 1831558550 |
|---|---|
| Former Name | MIKAYLA S |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 3160) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2024-02-02 |