| NPI | 1992364798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC10603) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LGP8797) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2022-09-28 |