| NPI | 1104407626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701010423) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health (Licence: VA 0701010423) | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2024-03-07 |