| NPI | 1356189864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC61666413) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 947842) |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2025-08-18 |