| NPI | 1568864544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 8968) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 19440) |
| 101YP2500X Counselor, Professional (Licence: MN 2109) | |
| 101YP2500X Counselor, Professional (Licence: ID LCPC-7297) | |
| Enumeration Date | 2014-09-21 |
| Last Update Date | 2024-10-02 |