| NPI | 1215745401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LCPC04080) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 4708) |
| Enumeration Date | 2024-12-20 |
| Last Update Date | 2025-11-07 |