| NPI | 1417605833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401222623) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL TPMC5026) |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2026-04-09 |