| NPI | 1104230234 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4395) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60476549) | 
| Enumeration Date | 2014-06-17 | 
| Last Update Date | 2022-09-26 |