| NPI | 1124795711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401224426) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6451022329) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2025-08-06 |