| 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 |