| NPI | 1629135033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 2003) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401006200) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2025-08-25 |