| NPI | 1649692831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401222858) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401222858) |
| 103TC1900X Psychologist Counseling (Licence: MI 6361006058) | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2025-02-17 |