| NPI | 1568105948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 8541-226) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 8541-226) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 8541-226) | |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2025-08-25 |