| NPI | 1114460425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401225325) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MI 6401015216) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2025-07-19 |