| NPI | 1912336165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R10748) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH25749) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2025-03-26 |