| NPI | 1912488081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 003804) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 008647) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2025-03-06 |