| NPI | 1043680093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 16342) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401334109) |
| Enumeration Date | 2015-10-03 |
| Last Update Date | 2025-08-19 |