| NPI | 1871782243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ID LCPC4891) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ID 3874) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2023-12-01 |