| NPI | 1598853947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0704018704) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413545) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-11-10 |