| NPI | 1215110135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 6286) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CT 007256) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2025-08-13 |