| NPI | 1922773514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401223554) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401223554) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2024-05-10 |