| NPI | 1912087420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AL LPC04125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MS 1077) |
| 101YP2500X Counselor Professional (Licence: MS 1077) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-08-23 |