| NPI | 1528808144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI LPC12022-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7738) |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2026-03-11 |