| NPI | 1972925717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC5061) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME XL4405) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2020-01-09 |