| NPI | 1124686860 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 9744)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: SD LPC20673)  | 
| Enumeration Date | 2019-05-29 | 
| Last Update Date | 2025-07-14 |