| NPI | 1891143996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401017213) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: MI 6401017213) | |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-12-03 |