| NPI | 1972142057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 101305) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH17672) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2023-09-14 |