| NPI | 1396158903 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 0680078567) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60532248) | 
| Enumeration Date | 2014-06-11 | 
| Last Update Date | 2025-10-22 |