| NPI | 1902211535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC LPC-I5563) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 5563) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2018-04-17 |