| NPI | 1104567197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC15161) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 9595) |
| 101YM0800X Counselor, Mental Health (Licence: NC 20444) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-09-24 |