| NPI | 1912607755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA PLC8330) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLC8330) |
| 101YS0200X Counselor, School (Licence: LA PLC8330) | |
| 101Y00000X Counselor (Licence: LA PLC8330) | |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2023-06-16 |