| NPI | 1285019570 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC6318) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC007975) | 
| Enumeration Date | 2015-07-28 | 
| Last Update Date | 2023-05-02 |