| NPI | 1053876870 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WV 2330)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV 2330)  | 
| 101Y00000X Counselor (Licence: KY 263839)  | |
| Enumeration Date | 2019-02-06 | 
| Last Update Date | 2025-03-24 |