| NPI | 1922574060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701007769) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701007769) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2018-10-16 |