| NPI | 1356755540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.009191) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA LPC013953) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2025-10-12 |