| NPI | 1962133355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC15472) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC15472) |
| 101YP2500X Counselor Professional (Licence: CO LPC.0021248) | |
| 101YP2500X Counselor Professional (Licence: NY 014138) | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2024-10-06 |