| NPI | 1366808230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 7673) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OK 7673) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2026-07-06 |