| NPI | 1013328616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4558) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-19830) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2025-03-24 |