| NPI | 1912575697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI LH61174373) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61174373) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-06-17 |