| NPI | 1366162240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 6164) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: RI MHC01584) |
| 101YM0800X Counselor Mental Health (Licence: NY 012381) | |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2023-10-30 |