| NPI | 1396062295 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 012646) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 5403) | 
| Enumeration Date | 2010-05-01 | 
| Last Update Date | 2025-05-23 |