| NPI | 1336848340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL 21501) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 101YM0800X Counselor Mental Health | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2023-02-28 |