| NPI | 1639825599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC14780) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 3153) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2025-09-05 |