| NPI | 1104604180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 19125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2026-08-19 |