| NPI | 1922641059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH86124) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN 3191) |
| 101YP2500X Counselor Professional (Licence: OK 6347) | |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |