| NPI | 1275148801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0904014759)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I.2204088)  | 
| Enumeration Date | 2020-09-10 | 
| Last Update Date | 2023-01-19 |