| NPI | 1649598228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc00139) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH2198) |
| 101YP2500X Counselor, Professional (Licence: SD LPC1184) | |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2025-10-09 |