| NPI | 1194683292 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2026-01-15 |
| Last Update Date | 2026-01-15 |