| NPI | 1902099302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 104184) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 104184) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-07-21 |