| NPI | 1891218590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 13111) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 13111) |
| 101YM0800X Counselor, Mental Health (Licence: NC A13111) | |
| 101YP2500X Counselor, Professional (Licence: NC A13111) | |
| 101YP2500X Counselor, Professional (Licence: NC 13111) | |
| 251S00000X Community/Behavioral Health (Licence: NC A13111) | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2021-11-19 |