| NPI | 1235912221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A20056) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NC 2021-7136-01) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2024-05-24 |