| NPI | 1962822767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO .0014117) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO .0013681) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2020-12-21 |