| NPI | 1407437122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-62685) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 61437708) |
| 101YM0800X Counselor, Mental Health (Licence: WA MC61189885) | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2023-07-31 |