| NPI | 1992944870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MS 1923) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MS 1923) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional (Licence: MS 1923) | |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2025-01-29 |