| NPI | 1104882679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10788) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH 10788) | 
| 101Y00000X Counselor (Licence: FL MH10788) | |
| Enumeration Date | 2006-04-25 | 
| Last Update Date | 2025-09-25 |