| NPI | 1922697739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MH19435) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH18464) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2022-11-11 |