| NPI | 1164765152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 4560) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 9864) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2025-07-19 |