| NPI | 1174368575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
| 1041C0700X Social Worker, Clinical | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-06-27 |