| NPI | 1528261799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.006389) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.0006389) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2025-09-11 |