| NPI | 1912542895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 10299125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 0501216) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2023-03-06 |