| NPI | 1083823249 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL 42685) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 1460) | 
| 101YM0800X Counselor, Mental Health (Licence: FL MH3340) | |
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2025-09-11 |