| NPI | 1962942607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 4258) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL C2826A) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2021-11-11 |