| NPI | 1912102310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 854) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1812) |
| 101YM0800X Counselor, Mental Health (Licence: NE 8324) | |
| 101YM0800X Counselor, Mental Health (Licence: IA 082666) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-10-01 |