| NPI | 1003746801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-24982) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 1281717) |
| Enumeration Date | 2026-05-22 |
| Last Update Date | 2026-08-12 |