| NPI | 1912511015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 011355) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NJ 37PC00984500) |
| 101YM0800X Counselor Mental Health (Licence: OR C8355) | |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2024-08-11 |