| NPI | 1053700831 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16550) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3595) | 
| 101Y00000X Counselor (Licence: CO LPC.0016476) | |
| Enumeration Date | 2015-01-15 | 
| Last Update Date | 2025-10-12 |