| NPI | 1225720717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 8331513) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: ID LPC-9479) |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2025-06-26 |