| NPI | 1245767227 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC2022)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC2022)  | 
| Enumeration Date | 2017-05-22 | 
| Last Update Date | 2025-01-14 |