| NPI | 1033908058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 25-QMHP-R3534) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA LCSW2120190) |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-23 |