| NPI | 1962801811 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LPC-6134)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60463863)  | 
| Enumeration Date | 2014-08-16 | 
| Last Update Date | 2021-09-21 |