| NPI | 1952785586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC6380) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MD LC6380) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2019-08-07 |