| NPI | 1225696677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH20991) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701008344) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2025-12-30 |