| NPI | 1144068149 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701013404)  | 
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health | 
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-07-16 | 
| Last Update Date | 2024-07-16 |