| NPI | 1205371499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH20840) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 17616) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0021802) | |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2025-05-21 |