| NPI | 1609260983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401020227) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI L219890) |
| 171W00000X Contractor (Licence: MI L219890) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2025-11-11 |