| NPI | 1023604139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 108627) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH30701) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2026-04-21 |