| NPI | 1104551407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 17602) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 10651) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2025-05-14 |