| NPI | 1093502890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CTB20240755) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM CTB20250805) |
| Enumeration Date | 2025-04-23 |
| Last Update Date | 2025-10-29 |