| NPI | 1174094890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LCPC04149) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR C10211) |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2025-12-04 |