| NPI | 1205873692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NE 1199) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3035) |
| 101YM0800X Counselor Mental Health (Licence: NE 997) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2025-09-24 |