| NPI | 1396410304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-20108) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID MBTCOU-9845) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2026-02-05 |