| NPI | 1972048205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401013363) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401013363) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2022-02-03 |