| NPI | 1114238656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH25855) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6418-125) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2025-07-11 |