| NPI | 1043692684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 0173581) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM CCMH0173581) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2025-07-29 |