| NPI | 1063994176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C11588) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0017907) |
| 101YM0800X Counselor, Mental Health (Licence: MA 12254) | |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2026-06-04 |