| NPI | 1922618206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH8086) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH8086) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-12-10 |