| NPI | 1396883179 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2474125) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 184124) | 
| Enumeration Date | 2007-02-02 | 
| Last Update Date | 2025-09-11 |