| NPI | 1831708759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MT3959) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH12112) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-12-30 |