| NPI | 1053200402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW24966) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 24966) |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-11-17 |