| NPI | 1962928580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 14926) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0014803) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2019-11-12 |