| NPI | 1962098145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 251S00000X Community/Behavioral Health (Licence: VA 0704013634) | |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2023-07-03 |