| NPI | 1962759860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11910) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH8736) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2021-09-17 |