| NPI | 1003968678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL LPC-1615) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL 1615) |
| 101YP2500X Counselor, Professional (Licence: AL LPC-1615) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2023-09-07 |