| NPI | 1316612708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL IMH19656) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH24854) |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2025-01-02 |