| NPI | 1265135222 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC16910) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP13551) | 
| Enumeration Date | 2023-03-27 | 
| Last Update Date | 2025-08-27 |