| NPI | 1902351604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12189) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 12189) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2018-10-05 |