| NPI | 1205360229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60991090) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-70701) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-05-16 |