| NPI | 1629742978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-78437) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MT PSY-PSY-TMP-3549) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2025-04-04 |