| NPI | 1235487935 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-28 | 
| Last Update Date | 2024-08-14 |