| NPI | 1376011023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH18139) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4214-226) | 
| Enumeration Date | 2018-11-09 | 
| Last Update Date | 2020-09-21 |