| NPI | 1033495114 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4684-125) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15832-130) | 
| 101YM0800X Counselor, Mental Health (Licence: WI 4684-125) | |
| Enumeration Date | 2011-11-02 | 
| Last Update Date | 2025-10-23 |