| NPI | 1003111527 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401018907)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401011423)  | 
| Enumeration Date | 2011-01-13 | 
| Last Update Date | 2022-05-18 |