| NPI | 1902379183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WV 2397) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV 934009) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC12240) | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2024-06-07 |