| NPI | 1568808111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61527329) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC15763) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2026-05-11 |