| NPI | 1073006813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401224717)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 156F00000X Technician/Technologist | |
| Enumeration Date | 2018-06-06 | 
| Last Update Date | 2024-10-16 |