| NPI | 1518730811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.019713) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL 178.019713) |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2026-04-21 |