| NPI | 1972105625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-67382) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-67382) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2024-05-22 |