| NPI | 1487254371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2024-12-02 |