| NPI | 1134796071 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH22641) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH21236) | 
| 104100000X Social Worker | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2021-06-09 | 
| Last Update Date | 2023-08-21 |