| NPI | 1063064822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 17253) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: CA 10955) | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2025-10-01 |