| NPI | 1649048067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11021) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL LPC05232) |
| 101YP2500X Counselor, Professional (Licence: TX 63535) | |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2024-07-19 |