| NPI | 1104961275 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA LMFT 151)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA LRC 50)  | 
| 101YP2500X Counselor, Professional (Licence: LA LPC 437)  | |
| Enumeration Date | 2007-02-20 | 
| Last Update Date | 2025-09-11 |