| NPI | 1215480165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 093854) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 2004) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2025-05-19 |