| NPI | 1609254598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LCPC04026) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 2686) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2025-07-16 |