| NPI | 1639808504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID 8911036) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ID 8911036) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-10-28 |