| NPI | 1174908503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401014949) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014949) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2025-11-14 |