| NPI | 1164862421 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR T1519) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-01 | 
| Last Update Date | 2025-06-20 |