| NPI | 1104636570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 740-125) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8557-123) |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |