| NPI | 1902352263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 12388) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 6446) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2021-06-29 |