| NPI | 1922750348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LGP12649) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH22124) |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-07-18 |