| NPI | 1104642073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC18036) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA APC000983) |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2026-06-17 |