| NPI | 1609451350 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH23994) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 8020-125) | 
| Enumeration Date | 2021-03-15 | 
| Last Update Date | 2024-08-26 |