| NPI | 1972191104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 11397) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NH EL05090) |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-03-18 |