| NPI | 1942722707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-7638) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-7638) |
| 101YP2500X Counselor, Professional (Licence: ID LCPC-7638) | |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-07-21 |