| NPI | 1073080610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 10429) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 274625) |
| 101YP2500X Counselor, Professional (Licence: KY 274625) | |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2025-07-22 |