| NPI | 1912357245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LGP6766) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD 8097) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-11-08 |