| NPI | 1689160822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180.014919) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 015886) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2025-08-08 |