| 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 |