| NPI | 1205316981 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC A14238) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 14238) | 
| Enumeration Date | 2018-08-21 | 
| Last Update Date | 2022-03-01 |