| NPI | 1639761729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C5569) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR C6695) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2025-06-04 |