| NPI | 1831747351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH21573) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: 7370) |
| 101YP2500X Counselor Professional (Licence: SC 7370) | |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2022-12-08 |