| NPI | 1922127315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 8153) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: RI 542) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2021-02-25 |