| NPI | 1902271679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 11689) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 11689) |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2022-11-14 |