| NPI | 1679347017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 11054-125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN 4116) |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2024-10-07 |