| NPI | 1912613902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS LPC03990) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2022015972) |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-01-24 |