| NPI | 1104456482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WV 2585) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 549) |
| Enumeration Date | 2020-01-25 |
| Last Update Date | 2025-01-30 |