| NPI | 1588432454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P138831) |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2025-10-14 |