| NPI | 1164254843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 0704015768) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0704015768) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2025-08-15 |