| NPI | 1043959638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C9021) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: AZ LPC-21496) | |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2026-07-28 |