| NPI | 1669099503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA LMHC10000960) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: RI MHC01625) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2025-07-28 |