| NPI | 1619776598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC5000781) |
| Additional Taxonomies | 225600000X Dance Therapist (Licence: MA 2608) |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-03-12 |