| NPI | 1255003877 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3322) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1506) | 
| 101YM0800X Counselor, Mental Health (Licence: IA 129284) | |
| Enumeration Date | 2021-10-01 | 
| Last Update Date | 2025-10-28 |