| NPI | 1619149200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401223900) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH10275) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2025-11-20 |