| NPI | 1124838073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-72775) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 72775) |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2026-03-03 |