| NPI | 1518469444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 4215) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 21772) |
| 101YM0800X Counselor, Mental Health (Licence: FL 25128) | |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2025-12-23 |