| NPI | 1992198204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15684) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 11779) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2018-05-23 |