| NPI | 1962033936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 276296) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 261646) |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2022-04-19 |