| NPI | 1043936313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-LIC-80976) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT BBH-PCLC-LIC-57583) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2025-07-23 |