| NPI | 1174067789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 010264) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 668) |
| 101YP2500X Counselor, Professional (Licence: GA 012731) | |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2025-09-16 |