| NPI | 1649975541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 251S00000X) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |