| NPI | 1235896622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C10065) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-23152) |
| Enumeration Date | 2021-11-21 |
| Last Update Date | 2026-08-04 |