| NPI | 1528580776 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC7432) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LPC-6341) | 
| Enumeration Date | 2017-07-10 | 
| Last Update Date | 2023-07-18 |