| NPI | 1376866301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12159) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 13049691-6004) |
| 101YP2500X Counselor, Professional (Licence: GA LPC012942) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2026-03-12 |