| NPI | 1982741161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT LCPC-1079) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 1079) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-09-22 |