| NPI | 1942703640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC009441) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: PA BH001491) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2019-07-12 |