| NPI | 1225450794 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC14661) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC5483) | 
| Enumeration Date | 2014-01-17 | 
| Last Update Date | 2020-05-21 |