| NPI | 1205608494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 12067-125) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 5098-226) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2026-01-29 |