| NPI | 1073178448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: LA 7432) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: LA MFT1346) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2023-12-20 |