| NPI | 1255166989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10540) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 017214) |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2025-12-29 |