| NPI | 1164201174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 90404) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61647075) |
| 101YM0800X Counselor, Mental Health (Licence: FL TPMC6036) | |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2025-04-21 |